Healthcare Provider Details

I. General information

NPI: 1861976854
Provider Name (Legal Business Name): NICOLE MARIE LAIRD LLPC, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 INDUSTRIAL DR
SALINE MI
48176-1741
US

IV. Provider business mailing address

301 W BENNETT ST
SALINE MI
48176-1155
US

V. Phone/Fax

Practice location:
  • Phone: 734-263-9276
  • Fax:
Mailing address:
  • Phone: 810-923-2842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401009191
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: